Concurrent therapy is defined in the Federal Register dated Thursday, May 10, 2001 page 23991. The reference is quoted below:

A beneficiary who is receiving concurrent therapy with one or more other beneficiaries likely is not receiving services that relate to those needed by any of the other participants. Although each beneficiary may be receiving care that is prescribed in his individual plan of treatment, it is not being delivered according to Medicare coverage guidelines; that is, the therapy is not being provided individually, and it is unlikely that the services being delivered are at the complex skill level required for coverage by Medicare. The Medicare SNF benefit provides coverage of therapy services only when the services are of such a level of complexity and sophistication (or the beneficiary's condition is such) that the services can be safely and effectively performed only by or under the supervision of a qualified professional therapist."

The RAI Users Manual defines concurrent therapy as follows:

"A licensed therapist starts work directly with one resident beginning a specific task. Once the resident can proceed with supervision, the licensed therapist works directly with a second resident to get him/her started on a different task, while continuing to supervise the first resident. The treatment ends for each resident 30 minutes after it begins. For each resident, record 30 minutes therapy time for each resident at Item P1bB. This delivery of therapy is often referred to as supervisory treatment, dovetailing, or concurrent therapy. Medicare B only recognizes individual (one-on-one) therapy and group therapy."

 

The Final Rule, 42 CFR Part 483, published by CMS on August 11, 2009 clarifies the use of concurrent therapy for FY 2011:

 

" As stated in the proposed rule, we believe that concurrent therapy can represent a legitimate mode of delivering therapy services when used properly based on individual care needs as determined by the therapist's professional judgment; should be an adjunct to individual therapy, not the primary mode of delivering care; and should represent an exception rather than the standard of care. We will utilize allocated concurrent therapy minutes to establish the RUG-IV group to which patients are assigned. In addition, we will require the therapist to track and report the three different delivery modes of therapy (individual, concurrent, and group) on the MDS 3.0. Considering the potential for inappropriate care, and that in some cases, patients may not be fully interacting with each other or the therapist throughout the concurrent therapy session, we believe that allocating concurrent therapy minutes is appropriate.  The only change is in the way the therapist records the time he or she spends with each patient."

The next Harmony newsletter will continue to summarize this document.

 
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